Provider Demographics
NPI:1861974610
Name:WILLIAMSON, KARA ASHLEY (DC)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:ASHLEY
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11966 LOUIS DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77705-8087
Mailing Address - Country:US
Mailing Address - Phone:409-749-4562
Mailing Address - Fax:
Practice Address - Street 1:721B NEDERLAND AVE
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-2445
Practice Address - Country:US
Practice Address - Phone:409-237-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13892111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor